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among persons who had dined at table d'hote, on Tuesday, the 18th July, at a hotel in that dislrict.
Some 90 persons were at dinner on that day, and of these upwards of 30 were attacked with symptoms
of gastro-enteritis and 2 deaths occurred. Inquiry was made by Dr. Lovett and by the medical man
who attended most of the patients, but they were not able to single out any special article of food as
being the cause of the illness. I submitted material from one of the fatal cases to Dr. Klein for
bacteriological examination. He found that (1) the intestinal fluid yielded a large number of typical
bacillus coli and proteus vulgaris, both normal inhabitants of the intestine ; (2) the intestinal fluid did
not yield the bacillus of Gartner—the colon-like microbe associated with meat poisoning in several
instances—nor did it contain the streptococcus of infective enteritis; (3) the intestinal fluid did not
contain the spores of the anaerobic bacillus enteritidis sporogenes associated with English cholera
and certain epidemics of diarrhoea; (4) the intestinal fluid contained an abundance of a slightly
mobile short bacillus which in its morphology and cultural characteristics differs from the hitherto
observed intestinal microbes. Dr. Klein thus describes this bacillus : " This bacillus is more or less
pointed at one end, generally is arranged as dumb-bells, and stains well after Gram's method. It
shows slight mobility and on staining for flagella, is seen to possess one, rarely two, fine spiral flagella.
It grows feebly and slowly aerobically, but shows good and rapid growth when cultivated anaerobically
in glucose gelatine and glucose broth. It forms on agar characteristic, round, translucent disc-shaped
colonies with dark centre, resembling those of streptococci. It grows well in milk, which it curdles
after three to seven days' incubation at 37 C. It produces slight acid when growing in litmus broth or
in litmus milk. It does not form indol in ordinary broth and produces in this only very slight
turbidity ; in sugar broth, cultivated anaerobically, it produces strong turbidity. It does not ferment
glucose and produces no gas in sugar gelatine or sugar agar." Experiments made to test the
pathogenicity of this microbe, with cultures grown both aerobically and anaerobically, on solid and in
fluid media and in milk, gave wholly negative results.
Disinfection.
I appended to my report for the year 1898 a report by Dr. Young, who had made inquiry for
the County Council into the provision made by sanitary authorities for the disinfection of infected
articles. The annual reports of medical officers of health show that in 1899 in Paddington,
Kensington and Battersea the authorities employ a contractor for this work. In Paddington and
Battersea the provision of steam apparatus by the sanitary authority was under consideration, and
there was probability that such provision would be made. In Kensington this change does not appear
to be contemplated. There are other districts of smaller size where the work was done by contract,
such as St. Martin-in-the-Fields and Rotherhithe, which under the London Government Act, 1899,
will be merged in other districts, and thus will probably have the opportunity of using the steam
apparatus situated within the area of the new borough. The same result will probably follow in the
case of St. George-in-the-East and St. Olave, now utilising apparatus belonging to hospitals. Mile-end
Old-town, Lee and Kidbrook, Eltham, Holborn and Stoke Newington contract with other authorities,
and the Act of 1899 will probably lead to new arrangements being made. The constitution of the
borough of Wandsworth will probably lead to reconsideration of the arrangements in the constituent
parishes which now employ a contractor. The greatest need for change is in the case of Charlton,
which does not use any disinfecting apparatus, and St. Saviour, Southwark, which has dry heat
apparatus. The constitution of metropolitan boroughs ought to bring to an end the delays which
have been primarily responsible for the unsatisfactory arrangements which have hitherto existed in
many parts of London.
Among the questions which should be considered in this connection is the need for provision of
laundry accommodation in connection with the apparatus for disinfection so as to obviate the necessity
of householders sending to public laundries articles which are infectious.
Provision of shelter during disinfection.
In connection with the steps taken by sanitary authorities to provide accommodation for people
who leave their houses while these are being disinfected, the reports of medical officers of health supply
the following information:—The Hackney Vestry have the plan6 prepared for this purpose, and these
plans were under consideration. The Bermondsey Vestry have decided to provide a shelter, and land
has been secured for this purpose near the Town-hall. The need for this provision has been pressing,
as during 1899 Dr. Dixon states, 82 families, including 101 adults and 132 children were dispossessed
of their homes during disinfection. In the City, Dr. Saunders reports, the tenancy of the house
previously used for this purpose being about to expire, the erection of a new building has been commenced
on the site of the old mortuary chapel. The ground floor is to be devoted to offices, caretaker's
rooms, a common room and lavatories, the first floor to rooms for women and children and the caretaker
; the second floor to two large rooms, one for men and boys and the other for women and girls,
with bath room and lavatories, and the third floor is reserved for contingencies. The old shelter was
used in 1899 by 12 families, comprising 22 adults and 18 children.
In Shoreditch it was found that the existing accommodation was unsatisfactory, and the vestry
decided to purchase a site and erect a shelter at a cost of £1,200. The site has been obtained. The
existing shelter was used in 1899 by 31 persons. The shelter in Woolwich now being erected was
nearly completed. The old shelter was used in 1899 by 11 families, including 31 persons. The
Lambeth Vestry has provided a new shelter in Wanless-road, the cost of the alteration of Arlingtonlodge
for this purpose being £541. The shelter at the wharf was used by four families in 1899. The
extent to which shelters are used varies much in the several districts. In St. George-the-Martyr, the
house was used in 1899 by 101 families comprising 358 persons. Dr. Waldo, points out that it was
most used by persons resident in the ward in which it is situated. In the Strand, St. Luke,
St. George-in-the-east, Plumstead and Greenwich parish, the shelter was not used during the year.
In the other districts for which the facts are stated in the annual reports, shelters were used in 1899 as
follows—Paddington by 21 families; St. George, Hanover-square, twice; Westminster by 21 families;
Marylebone, 11 times; St. Pancras by 8 families; Islington by 10 families ; Holborn and Clerkenwell
by 37 families; Shoreditch, 8 times; Limehouse by 10 families; St. Olave, 19 times; Deptford,
twice; Woolwich by 11 families.